Clinical experience, and diagnostic studies suggest that there is a high incidence of depression and anxiety disorders among alcoholics. This suggests that a subset of alcoholics may be "self- medicating" antecedent affective disorders. It would follow that in these individuals, appropriate pharmacologic treatment of the affective disorder would lead to resolution of alcoholism. Although imipramine is an effective treatment for depression, panic disorder, and agoraphobia, a series of placebo-controlled trials have failed to show any effect of imipramine on alcoholism. However, these trials suffer from poor methodology, most notably a failure to select samples of alcoholics with potentially imipramine responsive syndromes. We propose to conduct an open trial of imipramine in a sample of alcoholics selected for the presence of antecedent depression or panic disorder or agoraphobia based on psychiatric history. Patients will also concurrently receive focused alcoholism counseling. Patients who both become sober and experience improvement in their affective symptoms (target N=40) enter a double-blind, placebo controlled discontinuation trial, where half remain on imipramine while half switch to placebo. Counseling continues in both groups. The discontinuation trial is the most powerful design for preliminary studies, where the number of subjects is small, and the identifying features of probable medication responders are not well known. We hypothesize a higher rate of relapse to both affective disorder and alcoholism in the placebo group than in the imipramine group. We also propose to retrospectively examine our diagnostic data base for identifying features of imipramine responsive alcoholics.